Federal Adult Behavioral Health HCBS Person-centered Planning Process
Requirements/Characteristics
The individual will lead the person-centered planning process where possible.
The individual’s representative should have a participatory role, as needed and
as defined by the individual, unless State law confers decision making authority
to the legal representative. All references to individuals include the role of the
individual’s representative. In addition to being led by the individual receiving
services and supports, the person centered planning process:
Includes people chosen by the individual
Provides necessary information and support to ensure that the individual directs the
process to the maximum extent possible, and is enabled to make informed choices and
decisions
Is timely and occurs at times and locations of convenience to the individual.
Reflects cultural considerations of the individual and is conducted by providing
information in plain language and in a manner that is accessible to individuals with
disabilities and persons who are limited English proficient, consistent with §435.905(b) of
this chapter.
Includes strategies for solving conflict or disagreement within the process, including clear
conflict‑of‑interest guidelines for all planning participants.
Providers of Home‑ and Community‑Based Settings (HCBS) for the individual, or those
who have an interest in or are employed by a provider of HCBS for the individual must
not provide case management or develop the person‑centered service plan, except
when the State demonstrates that the only willing and qualified entity to provide case
management and/or develop person‑centered service plans in a geographic area also
provides HCBS. In these cases, the State must devise conflict of interest protections
including separation of entity and provider functions within provider entities, which must
be approved by CMS. Individuals must be provided with a clear and accessible alternative
dispute resolution process.
Offers informed choices to the individual regarding the services and supports they
receive and from whom.
Includes a method for the individual to request updates to the plan as needed.
Records the alternative HCBS settings that were considered by the individual (e.g., if the
individual agrees to receiving psychosocial rehab, the POC must document that the
individual was offered different settings to receive that service)
October 23, 2015
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